| Titre : | Black-white mortality from HIV in the United States before and after introduction of highly active antiretroviral therapy in 1996. (2007) |
| Auteurs : | Robert-S LEVINE ; Peter-T BALTRUS ; Nathaniel-C BRIGGS ; Yvonne FRY-JOHNSON ; HUSAINI (Baqar-A) : USA. Center for Health Research. Tennessee State University. Nashville. ; KILBOURNE (Barbara-S) : USA. Department of Sociology. Tennessee State University. Nashville. ; KING (William-D) : USA. Department of Internal Medicine. University of California. Los Angeles. ; George-S RUST |
| Type de document : | Article |
| Dans : | American journal of public health (vol. 97, n° 10, 2007) |
| Pagination : | 1884-1892 |
| Langues: | Anglais |
| Mots-clés : | Mortalité ; Epidémiologie ; Sida ; VIH ; Médicament antirétroviral ; Médicament antiviral ; Homme ; Virose ; Infection ; Rétrovirus ; Virus ; Amérique ; Immunopathologie ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST-CNRS bR0xOQzm. Diffusion soumise à autorisation]. Objectives. We sought to describe Black-White differences in HIV disease mortality before and after the introduction of highly active antiretroviral treatment (HAART). Methods. Black-White mortality from HIV is described for the nation as a whole. We performed regression analyses to predict county-level mortality for Black men aged 25-84 years and the corresponding Black : White male mortality ratios (disparities) in 140 counties with reliable Black mortality for 1999-2002. Results. National Black-White disparities widened significantly after the introduction of HAART, especially among women and the elderly. In county regression analyses, contextual socioeconomic status (SES) was not a significant predictor of Black : White mortality rate ratio after we controlled for percentage of the population who were Black and percentage of the population who were Hispanic, and neither contextual SES nor race/ethnicity were significant predictors after we controlled for pre-HAART mortality. Contextual SES, race, and pre-HAART mortality were all significant and independent predictors of mortality among Black men. Conclusions. Although nearly all segments of the Black population experienced widened post-HAART disparities, disparities were not inevitable and tended to reflect pre-HAART levels. Public health policymakers should consider the hypothesis of unequal diffusion of the HAART innovation, with place effects rendering some communities more vulnerable than others to this potential problem. |
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